Vegetative State, Persistent

Key Features

• Patients with severe bilateral hemispheric disease may show some improvement from an initially comatose state, so that, after a variable interval, they appear to be awake but display no movement

• This is called a "persistent" vegetative state once it has lasted over 4 weeks and has also been variously referred to as akinetic mutism, apallic state, or coma vigil

• Patients in a vegetative state from a medical cause (eg, anoxic brain injury) for more than 3 months and from a traumatic brain injury for more than 12 months are said to be in a chronic vegetative state, from which a few patients may regain consciousness but remain severely disabled

Clinical Findings

• Patients appear to be awake with open eyelids but lie motionless

• No evidence of awareness or higher mental activity

• Simulate coma

• Unresponsive

Diagnosis

• Obtain the expertise of a clinician familiar with this syndrome to aid in the diagnosis

• Now differentiated from the minimally conscious state

Treatment

• Supportive care, palliative care